Anthracycline‐induced cardiotoxicity on regional myocardial work and left ventricular mechanical dispersion in adolescents and young adults in post‐lymphoma remission
Abstract Background Myocardial work (MW) is a new echocardiographic tool with a high sensitivity to detect early and subtle alterations of myocardial function. We aimed to evaluate the late effects of anthracyclines by assessing the global and segmental MW and intraventricular mechanical dispersion...
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Wiley
2024-02-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.6857 |
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| author | Mohamed Jaber Alexandre Armand Emmanuelle Rochette Severine Monzy Victoria Greze Justyna Kanold Etienne Merlin Justine Paysal Stéphane Nottin |
| author_facet | Mohamed Jaber Alexandre Armand Emmanuelle Rochette Severine Monzy Victoria Greze Justyna Kanold Etienne Merlin Justine Paysal Stéphane Nottin |
| author_sort | Mohamed Jaber |
| collection | DOAJ |
| description | Abstract Background Myocardial work (MW) is a new echocardiographic tool with a high sensitivity to detect early and subtle alterations of myocardial function. We aimed to evaluate the late effects of anthracyclines by assessing the global and segmental MW and intraventricular mechanical dispersion from speckle tracking echocardiography in childhood lymphoma survivors (CLS). Methods Thirty‐one young adults including CLS and age‐matched healthy controls were enrolled. All underwent echocardiography including an evaluation of left ventricular (LV) morphology and regional function. We assessed LV longitudinal (differentiating sub‐endocardial and sub‐epicardial layers), circumferential strains and twist, global and regional MW index (MWI). LV mechanical dispersion was assessed from the time dispersion of LV longitudinal strain, from myocardial wasted work (MWW) and myocardial work efficiency (MWE). Results The longitudinal strains both at the level of the sub‐endocardium and sub‐epicardium were reduced in CLS compared to controls. The global MWI was also decreased (1668 ± 266 vs 1870 ± 264%.mmHg in CLS patients and controls, respectively, p < 0.05), especially on the apical segments. An increase of LV intraventricular mechanical dispersion was observed in CLS. MWW and MWE remained unchanged compared to controls. Conclusion Our results strongly support that cardiac remodeling is observed in CLS, characterized by a decrease in MW and an increase in LV mechanical dispersion. The apex is specifically altered, but its clinical significance remains uncertain. MW as a complement to strain seems interesting in cancer survivors to detect myocardial dysfunction at early stage and adapt their follow‐up. |
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| institution | Directory Open Access Journal |
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| language | English |
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| series | Cancer Medicine |
| spelling | doaj.art-4506dd725a12430aade20ddfc623a1542024-04-09T05:45:47ZengWileyCancer Medicine2045-76342024-02-01133n/an/a10.1002/cam4.6857Anthracycline‐induced cardiotoxicity on regional myocardial work and left ventricular mechanical dispersion in adolescents and young adults in post‐lymphoma remissionMohamed Jaber0Alexandre Armand1Emmanuelle Rochette2Severine Monzy3Victoria Greze4Justyna Kanold5Etienne Merlin6Justine Paysal7Stéphane Nottin8CHU Clermont‐Ferrand, Pédiatrie Générale Clermont‐Ferrand FranceCHU de Clermont‐Ferrand, Service Hématologie Oncologie Pédiatrique Clermont‐Ferrand FranceCHU Clermont‐Ferrand, Pédiatrie Générale Clermont‐Ferrand FranceCardiologue libéral, Pôle Santé République Clermont‐Ferrand FranceCHU de Clermont‐Ferrand, Service Hématologie Oncologie Pédiatrique Clermont‐Ferrand FranceCHU de Clermont‐Ferrand, Service Hématologie Oncologie Pédiatrique Clermont‐Ferrand FranceCHU Clermont‐Ferrand, Pédiatrie Générale Clermont‐Ferrand FranceCHU de Clermont‐Ferrand, Service Hématologie Oncologie Pédiatrique Clermont‐Ferrand FranceLaboratory of Cardiovascular Adaptations to Exercise Avignon FranceAbstract Background Myocardial work (MW) is a new echocardiographic tool with a high sensitivity to detect early and subtle alterations of myocardial function. We aimed to evaluate the late effects of anthracyclines by assessing the global and segmental MW and intraventricular mechanical dispersion from speckle tracking echocardiography in childhood lymphoma survivors (CLS). Methods Thirty‐one young adults including CLS and age‐matched healthy controls were enrolled. All underwent echocardiography including an evaluation of left ventricular (LV) morphology and regional function. We assessed LV longitudinal (differentiating sub‐endocardial and sub‐epicardial layers), circumferential strains and twist, global and regional MW index (MWI). LV mechanical dispersion was assessed from the time dispersion of LV longitudinal strain, from myocardial wasted work (MWW) and myocardial work efficiency (MWE). Results The longitudinal strains both at the level of the sub‐endocardium and sub‐epicardium were reduced in CLS compared to controls. The global MWI was also decreased (1668 ± 266 vs 1870 ± 264%.mmHg in CLS patients and controls, respectively, p < 0.05), especially on the apical segments. An increase of LV intraventricular mechanical dispersion was observed in CLS. MWW and MWE remained unchanged compared to controls. Conclusion Our results strongly support that cardiac remodeling is observed in CLS, characterized by a decrease in MW and an increase in LV mechanical dispersion. The apex is specifically altered, but its clinical significance remains uncertain. MW as a complement to strain seems interesting in cancer survivors to detect myocardial dysfunction at early stage and adapt their follow‐up.https://doi.org/10.1002/cam4.6857anthracyclinechildhood lymphoma survivorsintraventricular mechanical dispersionmyocardial workregional myocardial functionspeckle tracking echocardiography |
| spellingShingle | Mohamed Jaber Alexandre Armand Emmanuelle Rochette Severine Monzy Victoria Greze Justyna Kanold Etienne Merlin Justine Paysal Stéphane Nottin Anthracycline‐induced cardiotoxicity on regional myocardial work and left ventricular mechanical dispersion in adolescents and young adults in post‐lymphoma remission Cancer Medicine anthracycline childhood lymphoma survivors intraventricular mechanical dispersion myocardial work regional myocardial function speckle tracking echocardiography |
| title | Anthracycline‐induced cardiotoxicity on regional myocardial work and left ventricular mechanical dispersion in adolescents and young adults in post‐lymphoma remission |
| title_full | Anthracycline‐induced cardiotoxicity on regional myocardial work and left ventricular mechanical dispersion in adolescents and young adults in post‐lymphoma remission |
| title_fullStr | Anthracycline‐induced cardiotoxicity on regional myocardial work and left ventricular mechanical dispersion in adolescents and young adults in post‐lymphoma remission |
| title_full_unstemmed | Anthracycline‐induced cardiotoxicity on regional myocardial work and left ventricular mechanical dispersion in adolescents and young adults in post‐lymphoma remission |
| title_short | Anthracycline‐induced cardiotoxicity on regional myocardial work and left ventricular mechanical dispersion in adolescents and young adults in post‐lymphoma remission |
| title_sort | anthracycline induced cardiotoxicity on regional myocardial work and left ventricular mechanical dispersion in adolescents and young adults in post lymphoma remission |
| topic | anthracycline childhood lymphoma survivors intraventricular mechanical dispersion myocardial work regional myocardial function speckle tracking echocardiography |
| url | https://doi.org/10.1002/cam4.6857 |
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